{"title":"Current state, challenges, unmet needs, and future directions in the pharmacological treatment of biliary tract cancer.","authors":"Michael H Storandt, Amit Mahipal","doi":"10.1080/17512433.2025.2546149","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>There has been a significant change in the treatment paradigm of biliary tract cancers (BTCs) in recent years with the introduction of chemoimmunotherapy and the development of targeted agents. In the present review, we describe the current landscape of systemic therapy for BTC and discuss forthcoming novel therapeutics.</p><p><strong>Areas covered: </strong>We completed a narrative review using pertinent clinical trials discussing systemic therapy for BTC listed on PubMed, as well as ongoing trials included on clinicaltrials.gov. We discuss evidence for use of systemic therapy in the adjuvant setting and review first- and second-line systemic therapy, including targeted agents, for treatment of advanced BTC.</p><p><strong>Expert opinion: </strong>Despite advances in systemic therapy for BTC, there is a high incidence of recurrence for resected diseases and the prognosis for metastatic diseases remains poor. Development and assessment of novel therapeutics will be essential going forward, as will research regarding means to overcome resistance mechanisms that limit efficacy of targeted agents.</p>","PeriodicalId":12207,"journal":{"name":"Expert Review of Clinical Pharmacology","volume":" ","pages":"563-575"},"PeriodicalIF":3.0000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Clinical Pharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17512433.2025.2546149","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: There has been a significant change in the treatment paradigm of biliary tract cancers (BTCs) in recent years with the introduction of chemoimmunotherapy and the development of targeted agents. In the present review, we describe the current landscape of systemic therapy for BTC and discuss forthcoming novel therapeutics.
Areas covered: We completed a narrative review using pertinent clinical trials discussing systemic therapy for BTC listed on PubMed, as well as ongoing trials included on clinicaltrials.gov. We discuss evidence for use of systemic therapy in the adjuvant setting and review first- and second-line systemic therapy, including targeted agents, for treatment of advanced BTC.
Expert opinion: Despite advances in systemic therapy for BTC, there is a high incidence of recurrence for resected diseases and the prognosis for metastatic diseases remains poor. Development and assessment of novel therapeutics will be essential going forward, as will research regarding means to overcome resistance mechanisms that limit efficacy of targeted agents.
期刊介绍：
Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery.
Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.
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